BOROUGH OF BROOKLYN CERTIFICATE OF DEATH

DIVISION OF RECORDS
DEPARTMENT OF HEALTH
BOROUGH OF BROOKLYN
CERTIFICATE OF DEATH # 156-63-326117
NAME OF DECEASED: Anna Bolton
PLACE OF DEATH: 1020 Ocean Pkwy.
Brooklyn, New York
USUAL RESIDENCE: 39 Turner Place
Brooklyn, Kings County
LENGTH OF RESIDENCE: 30 Years
SEX: Female
MARITAL STATUS: Widowed
DATE OF BIRTH: (not given)
AGE: 80 Years
USUAL OCCUPATION: Housewife
BIRTHPLACE: Russia
CITIZEN OF WHAT COUNTRY: USA
FATHER'S NAME: Mitchel Warshaw
MOTHER'S MAIDEN NAME: Dianah Jaffe
INFORMANT: Tessie Bolton, daughter
39 Turner Place
DATE OF DEATH: December 22, 1963 (P.M.)
CAUSE OF DEATH: Arteriosclerotic cardiovascular disease
CERTIFICATION: I hereby certify that in
accordance with the provisions
of law, I took charge of the
dead body at 1152 Coney Island
Hospital this 24th day of
December 1963.I further
certify from the investigation
and post mortem examination
without autopsy that, in my
opinion, death occurred on the
date and at the hour stated
above and resulted from natural
causes.
PLACE OF BURIAL: New Montefiore Cemetery
Pinelawn, New York
DATE OF BURIAL: December 24, 1963
FUNERAL DIRECTOR: Kirschenbaum Bros. Inc.
1153 Coney Island Avenue

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